This proposal is the first competing renewal of a grant initially funded in 2003 in response to the RFA HD- 02-019 for NICHD Institutional Training for Pediatricians. Our application requests ongoing resources to train 4 pediatricians with an M.D. or M.D./PhD. degree each year in pediatric research in the Department of Pediatrics at the University of California San Francisco (UCSF). In the first 4 years of this award we have supported the training of 12 pediatric subspecialty fellows (4 men and 8 women). All 5 trainees who have finished their fellowships have academic appointments (4 at UCSF) and two-thirds of the fellows with at least three years of post-doctoral training have submitted or hold a career development award (K award). The Department of Pediatrics at UCSF is strongly committed to producing young pediatric researchers who are passionate about translating scientific data to enhance the health of children. The goal therefore of this T32 application is to provide rigorous scientific training and extensive career mentoring to pediatric subspecialty fellows who are committed to a sustained career in research is highly relevant to pediatric disease. We anticipate that most scholars will emphasize either Tl (Laboratory to Human Subjects) or T2 (Evidence to Practice) research and outline appropriate training components specific to each pathway. However, we also recognize that some trainees will pursue projects that will integrate elements of Tl and T2 investigation or that research and career goals may shift during the period of T32 support. For this reason, the program is designed to work proactively with each T32 scholar to design and implement an optimal training program. The training program for Tl and T2 fellows consists of the following four key elements: (1) a mentored research experience; (2) scientific course work; (3) interdisciplinary experiences and career development workshops; and, (4) ongoing review and evaluation. A well-established mentoring program is in place. The objective goals of the T32 program are to have 90% of the graduates enter academic medicine at the completion of training (actual performance to date 100%), 80% remain in academic medicine for greater than 5 years, two-thirds of the graduates apply for a K award within 12 months of completing training (actual performance to date 63%), and 50% of graduates to have an independent, federally-funded grant within 5 years of graduation (not enough time has passed to evaluate performance on this metric).